Loughborough academics part of new project investigating effectiveness of personalized breast cancer screening

Loughborough University academics are to conduct research as part of a large-scale international project investigating whether personalized breast cancer screening is a better screening option for women aged 40 to 70.

Dr Yan Chen and Emeritus Professor Alastair Gale, of the School of Science, say they are "very proud" to be part of MyPeBS (My Personalized Breast Screening) - a unique seven-year-long randomized clinical study that will run trials with 85,000 women from five different countries to compare personalized risk-based screening to standard screening.

MyPeBS has received 12.5 million euros (£11.2m) of funding from the European Union's Horizon 2020 research and innovation program and brings together 25 European, Israeli and American groups and institutions.

Since the late 1980s, organized breast mammography screening programs have been introduced in more and more countries across Europe, and these programs have always used a "one size fits all" strategy whereby women in a target age group (typically between 50-69-years-old) are invited for a mammogram every two or three years.

This approach has demonstrated benefits (reduction of breast cancer-specific mortality by 20%), however, researchers say it is not perfect and comes with side effects including false-positive findings, overdiagnosis and overtreatment.

In the current strategy, all invited women are treated the same, but each woman has her own individual risk of developing breast cancer depending on factors such as genetics, lifestyle, or hormonal exposure.

MyPeBS is investigating the advantages of using a new screening approach based on individual risk estimation of breast cancer.

Radiologists will assess each woman and make an informed recommendation for when they should undertake screenings.

For example, a woman who has a family history of breast cancer may be classed as 'high risk' and advised to have a yearly screening, whereas a woman with no family history of breast cancer and no other risk indicators may be told a screening of every four years would be more appropriate.

The study will compare two groups of women - one following the current standard breast screening and the other following a personalized risk-based screening strategy.

In the MyPeBS trial, some 300 radiologists will report breast screening cases across five countries - Belgium, France, Israel, Italy, and the United Kingdom - therefore it is important to monitor their performance and ensure that there is an established standard of performance and equivalence of skill levels in identifying any breast abnormalities.

Dr Chen, Director of the University's Applied Vision Research Centre, and Professor Gale will act as the quality assurance for the trials; they will analyze information provided by radiologists regarding their reporting mammographic workstation and relevant reporting room characteristics.

They will also ensure the radiologists can read scans to the highest level by getting them to complete PERFORMS test sets of known challenging cases every six months in the first two years.

PERFORMS is an online self-assessment and training resource for breast screening radiologists developed and ran by Loughborough University academics for the past 30 years.

The results of these tests will be fed back to the participants and reported to the MyPeBS co-ordinators.

Dr Chen will also compare results with the University of California (UoC), which will carry out similar assessments using their training resource, WISDOM.

The UoC work is being led by Dr Laura Esserman, who was a member of President Obama's Council of Advisors on Science and Technology (PCAST) Working Group on Advancing Innovation in Drug Development and Evaluation.

Of the study, Dr Chen said: "We're very proud to be part of the MyPeBS project.

"It is important that, on the basis of sound scientific evidence, breast screening be offered appropriately and regularly to those women who most need it and less often to those women who least need it. This detailed study will determine which women are most at risk of this dreadful disease."

The MyPeBS clinical study will begin in early 2019. After the results of the study are known, MyPeBS will propose general recommendations for more effective breast cancer screening in Europe.

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